I. General Work Arrangement
1. This is a temporary agreement due to a campus emergency between ______________________ and
________________________ to establish the terms and conditions for performing work at an alternate
work site.
2. This agreement begins on ____________ and continues until ____________. The parties
acknowledge that the employee’s work quality, efficiency, and productivity are not compromised by
the arrangement described herein. The details of this remote work arrangement are as outlined in
Appendix A. The employee will maintain a record of work hours and work performed for the duration
of this arrangement using Appendix B.
3. While remote working, employee will:
a. remain accessible during the remote work schedule;
b. check in with the supervisor to discuss status and open issues;
c. be available for teleconferences, scheduled on an as-needed basis;
d. request supervisor approval in advance of working any overtime hours (if employee is non-
exempt); and
e. request supervisor approval to use vacation, sick, or other leave in the same manner as when
working at employee’s regular work location.
4. Employee’s duties, obligations, responsibilities, and conditions of employment with the University
remain unchanged except those responsibilities specifically addressed in this agreement. Any
alterations in FTE or job responsibilities will be denoted in Appendix A. Job responsibilities, standards
of performance, and performance appraisals remain the same as if working at the regular University
work site. The supervisor reserves the right to assign work as necessary at any remote work site.
5. The parties acknowledge that this agreement may be evaluated on an ongoing basis to ensure that
Employee’s work quality, efficiency, and productivity are not compromised by the remote
arrangement described herein.
6. Employee agrees to protect University-owned equipment, records, and materials from unauthorized
or accidental access, use, modification, destruction, or disclosure. The precautions described in this
agreement apply regardless of the storage media on which information is maintained, the locations
where the information is stored, the systems used to process the information, or the process by which
the information is stored.
7. Out of pocket expenses for supplies normally available through the University will not be reimbursed.
The University will not be responsible for operating costs, home maintenance, or any other incidental
cost associated with the use of the home as an alternate work location. The employee must maintain
the ability to connect to the University’s network with a sufficient bandwidth to perform the job duties.
8. Employee understands that some information (electronic and hard copy) used in their work may be
deemed confidential by the University and will apply the University’s confidentiality and document
retention policies at the same level as in the regular office in order to protect such information from
unauthorized disclosure, loss or damage.
9. Any remote work agreement may be modified or cancelled with 24 hours written notice.
10. Employees are expected to maintain connectivity to perform work. Any loss of connectivity must be
reported to their supervisor immediately.
11. Employee agrees to maintain a safe, secure, and ergonomic work environment and to report work-
related injuries immediately to Employee’s supervisor. Employee agrees to hold the University
harmless for injury to others at the alternate work site. The University is not liable for damages to the
employee’s personal or real property.
12. The parties acknowledge that non-exempt employees are not allowed to work overtime without prior
management approval in writing.
II. Job Characteristics Best Suited to Remote Work
Include tasks that can be performed off site and sent to and from the employee’s home with
ease, speed and confidentiality.
Require independent work, such as writing, reading, telephoning, planning, computer
programming, word processing and data entry.
Require limited face-to-face interaction with managers, colleagues, clients or subordinates.
Have clearly defined tasks, objectives and work products.
Have measurable work activities or products.
Have objectives with identifiable time frames and check points.
Can be monitored by output, not time spent doing the job.
Have minimal requirements for special equipment or access to materials and files located at
the office or regular work location.
Can be performed while meeting University security requirements.
1. Departmental justification for remote work:
2. Remote Work Location (address):_____________________________________________________
3. Alternate phone number #1: ( )____________________________________________________
4. Alternate e-mail address, if applicable: ______________________________________________
3. The employee will remote work _____days per week.
4. The employee’s work hours will be from _____a.m. to ______p.m. The employee agrees to be available
by phone and email during these core hours.
5. The following is a list of the tasks/assignments to be worked on by the employee at the remote location,
with expected delivery dates:
Delivery Date
6. The following is a list of scheduled meetings via teleconference for supervisor/employee discussions to
review progress on the assigned tasks:
__________________________________ _______________________________________
7. The following is a list of university-owned equipment, software, and/or supplies to be utilized at the remote
work location:
Equipment (description):
Serial/Property Number:
I hereby affirm by my signature that I have read this agreement and understand and agree to all
of its provisions.
Date Department Head Name Signature
Date Supervisor Name Signature
Date Employee Name Signature
Employee Name
Employee ID
Supervisor Name